title: The family APGAR and psychosocial problems in children: a report from ASPN and PROS.
abstract: BACKGROUND
  Our study examined whether the lack of social support as measured by the Family APGAR was related to parents' and physicians' identification of child psychosocial problems and sociodemographic and symptom characteristics of the children screened.
  
  
  METHODS
  The parents of 9626 children, ages 4 to 15 years, seen for outpatient medical visits participated in this national study. Parents completed the Family APGAR and the Pediatric Symptom Checklist (PSC), a measure of psychosocial dysfunction. Physicians rated the presence of a new or recurrent psychosocial problem in the child.
  
  
  RESULTS
  Children from families with a lack of social support were 4.3 times as likely to receive scores indicating impairment on the PSC and 2.2 times as likely to be identified as having psychosocial problems by physician report. Families with low social support were significantly more likely to report low parental educational achievement, single parent status, and a history of mental health services for the child. Fifty percent of children from families with low social support were identified as having a psychosocial problem by either the PSC or physician rating, or both; however, only 21% of the children identified with psychosocial impairment by these two measures had scores indicating poor family functioning on the Family APGAR.
  
  
  CONCLUSIONS
  A lack of family social support is associated with child psychosocial dysfunction as assessed by two different measures. However, the Family APGAR was not a sensitive measure of child psychosocial problems, and thus it supplements, but does not replace, information concerning the child's overall psychosocial functioning.
authors.affiliation: Child Psychiatry Service, Massachusetts General Hospital, Boston 02114, USA.
authors.forename: J M
authors.initials: JM
authors.lastname: Murphy
authors.forename: K
authors.initials: K
authors.lastname: Kelleher
authors.forename: M E
authors.initials: ME
authors.lastname: Pagano
authors.forename: C
authors.initials: C
authors.lastname: Stulp
authors.forename: P A
authors.initials: PA
authors.lastname: Nutting
authors.forename: M S
authors.initials: MS
authors.lastname: Jellinek
authors.forename: W
authors.initials: W
authors.lastname: Gardner
authors.forename: G E
authors.initials: GE
authors.lastname: Childs
mesh_terms: D000293:Adolescent; D000328:Adult; D000553:Ambulatory Care; D001034:Apgar Score; D002648:Child; D002653:Child Behavior Disorders / Q000175:diagnosis* / Q000523:psychology; D002675:Child, Preschool; D003710:Demography; D005190:Family / Q000523:psychology*; D005194:Family Practice; D005260:Female; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data; D010372:Pediatrics; D002666:Psychology, Child; D012106:Research; D012680:Sensitivity and Specificity; D012944:Social Support; D012961:Sociology